“I thought, who is this guy. We hadn’t thought that was a district of the city where much attention was being paid to AIDS,” said John Auerbach, a health professor at Northeastern University who was then the state health department’s AIDS director.

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“When it was controversial, and he had nothing to gain, he took a courageous stance,” Auerbach­ said. “That was a hallmark of the kind of leader he is.”

During his two decades as mayor, Menino has led some of the most successful campaigns to improve the health of Bostonians, from implementing a high-profile workplace smoking ban to pushing through the 1996 merger of Boston City Hospital and Boston University Medical Center to improve care for the city’s poorest residents.

In the early 2000s, when health advocates were trying, unsuccessfully, to get a statewide law limiting smoking at indoor workplaces, a consortium of Greater Boston communities debated a regional approach, hoping it would prompt state action.

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But each community had to pass its own regulations, an action many were hesitant to do because none wanted to be the first and risk losing restaurant and bar business to a neighboring town.

Menino and Auerbach, by then the city’s public health commissioner, were among the first to stand up, said Harold Cox, an associate dean at Boston University’s School of Public Health, who was then the chief public health officer in Cambridge.

“The fact that we had Mayor Menino to come out very early and say this is the right thing for Boston to do made it easier,” Cox said.

Last year, Boston became the first big city in Massachusetts — and the largest in the nation — to ban smoking in public housing.

Perhaps one of Menino’s greatest passions has been his drive to ensure equal access to quality health care, and to close that gap between rich and poor, black and white, say those who have worked with him on the front lines.

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In 2005, he launched a $1 million campaign to track ethnic and racial differences in health care and work with hospitals and other providers to address the problem.

“He identifies with the people in the city who are most vulnerable, at most risk for injury or illness or premature death,” Auerbach said. “It’s not a political stance; it’s who he is as a person.”

In 2008, after state health officials allowed drugstores such as CVS to open clinics to make routine care more convenient, Menino blasted them for not providing comprehensive services. While the suburbs are now dotted with the retail clinics, none have opened in Boston.

When a merger mania was rippling through Boston’s hospital industry in the mid-1990s, and some of the city’s elite institutions were joining forces, Menino brokered what many at the time thought to be an improbable union of financially troubled Boston City Hospital with the academic Boston University Medical Center.

“It was a way in which the mayor could secure quality academic health care, particularly for those on Medicaid and the indigent poor,” said David Passafaro, a Boston Medical Center board member who was then Menino’s chief of staff.

One night, when negotiations at the city-owned Parkman House hit an impasse, Menino strode into the room, stripped off his watch, laid it on the table, and threatened to denounce intransigent parties on the 11 p.m. television news if a deal wasn’t done, Passafaro said.

They missed the deadline, but kept negotiating and reached a deal a couple of days later, said Passafaro, who remembers Menino whispering to him as he left that night, “Hey don’t forget my watch.”

In 2002, in honor of Menino’s unwavering support, the institution renamed the wing that houses its emergency department and inpatient rooms the Menino Pavilion.